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SEARCH: Large increase in diabetes rate among US youth
An analysis of data from the SEARCH for Diabetes in Youth Study demonstrated that diabetes types 1 and 2 are on the rise in American youth younger than 20 years.
The type 2 diabetes rate increased by 30.5% and was seen to increase equally in both sexes and across all age groups, according to the study findings.
Type 1 diabetes showed a 21% increase during the 8-year study period, with the greatest increases seen in teens aged 15 to 19 years.
Dana Dabelea, MD, PhD, of the Colorado School of Public Health, and colleagues surveyed data spanning 2001 to 2009 from five collection sites in California, Colorado, Ohio, South Carolina and Washington. The data comprise the SEARCH for Diabetes in Youth Study, a collaborative study effort sponsored by the CDC and the National Institute of Diabetes and Digestive and Kidney Diseases, part of the NIH. Data on more than 3.3 million children, adolescents and teens were used to determine disease rates in this study. The main study outcome measured the prevalence per 1,000 participants of physician-diagnosed type 1 diabetes in youth aged 0 to 19 years, and type 2 diabetes in youth aged 10 to 19 years.
Dana Dabelea
In 2001, prevalence for type 1 diabetes was 1.48 per 1,000 (95% CI, 1.44-1.52). In 2009, prevalence for type 1 diabetes was 1.93 per 1,000 (95% CI, 1.88-1.97), with the highest prevalence in white youth (2.55 per 1,000; 95% CI, 2.48-2.62) and the lowest in American Indian youth (0.35 per 1,000; 95% CI, 0.25-0.47).
In a statement on the study, Richard Insel, MD, chief scientific officer of the Juvenile Diabetes Research Foundation (JDRF), commented on the implications of rising type 1 diabetes rate in minority youth.
“The data confirm what JDRF and many public health experts have long suspected: The incidence of type 1 diabetes is on the rise in youth across all ethnic groups in the United States, and the disease is now having a more significant impact on black and Hispanic youth populations, which previously had relatively low rates of the disease,” Insel said. “As the study's authors noted, the increased prevalence of type 1 diabetes among a more diverse population of children and teens is also of concern since minority youth have historically experienced poor glycemic control, which is known to be associated with diabetic complications.”
Dabelea and colleagues noted that the study is the first to examine multiethnic changes in type 2 diabetes rates. Findings showed that type 2 diabetes increased most significantly in white, Hispanic and black youth, whereas no changes in disease rates were found for Asian Pacific Islander and American Indian youth.
In 2001, type 2 diabetes was present in 0.34 of 1,000 youth of all races (95% CI, 0.31-0.37). In 2009, type 2 diabetes prevalence increased to 0.46 per 1,000 (95% CI, 0.43-0.49) in all races, with 1.06 per 1,000 black youth (95% CI, 0.93-1.22); 0.79 per 1,000 for Hispanic youth (95% CI, 0.7-0.88); and 0.17 per 1,000 for white youth (95% CI, 0.15-0.2).
“Several reasons for increasing type 2 diabetes prevalence are possible. Most likely are real changes in population risk for type 2 diabetes, such as minority population growth, obesity, exposure to diabetes in utero, and perhaps endocrine-disrupting chemicals,” the researchers wrote.
Disclosure: The researchers reported receiving financial support from the American Diabetes Association, American Heart Association, CDC, JDRF, Merck, NIH, US Army Medical Research Acquisition Activity and the USDA. See the study for a complete list of relevant financial disclosures.